The patient came to the clinic 03-October-2004 complaining of numbness four limbs for 2 years, gradually deteriorating to include the legs and inability to walk. Neck pain for 2 years. Ataxic gait with fall to the right. Using crutches for 3 months. Difficulty breathing the last 2 weeks. MRI cervical spine performed 19-April-2003 showing severe compression of the spinal cord at C3-4, 4-5, 5-6 with malacia of the spinal cord.

On examination, the patient having neck pain when turning the head to right and up. There is severe weak grip and extension right hand 2/5, left hand 3/5 and both triceps muscle 2/5. Weak left deltoid 4/5. There is hypalgesia of the entire both upper limbs and down. All the muscles of the lower limbs are weak more the right lower limb 3-4/5. Hoffman positive both sides. There slight scoliotic stance. SLRS was 30 degrees both sides without pain due to weakness. All deep reflexes are exaggerated with Babinski positive both sides without clonus. The patient is limping due to weak both lower limbs, more right foot.

The patient was sent for investigations and MRI cervical spine done 09-October-2004 showing severe compression of the spinal cord at C3-4, 4-5, 5-6 and C6-7 with malacia of the spinal cord.

Transnasal intubation. Using the C-arm, the level of C3-4 was identified and discectomy of C3-4 was performed and the extruded pieces were removed until the dura was seen at the bottom of the removed disc cavity. The same was done for C4-5, C5-6 and C6-7 disci. Using Syntex cervical miniplate bended to accept the natural curve of the area, fusion of C3-4-5-6-7 was achieved with 10 screws. All stages were done with C-arm control. Routine closure of the wound. Smooth postoperative recovery. The power of the upper limbs dramatically improved.

The patient came to the clinic 23-October-2004 with clean wound and the motor power of four limbs normalized with shrinkage of the hypalgesia to the area of the left upper limb below the elbow and right lower limb below the right knee.

The patient came 03-November-2004 with acceptable check cervical X-ray showing the construct with full power four limbs, but still having diabetic neuropathy both feet.

The patient then came 03-July-2010 for report to accept him for work in bank.

The recurrence rate in cervical disc surgery is zero. Another disc can cause de novo extrusion.

In case of myelopathic syndrome, the recovery of the upper limbs is rapid, but the lower limbs needs more time to recover, but this case showed deviation from the rule, but the sensory deficit took more time to disappear.